On March 3, the Department of Obstetrics of the First Affiliated Hospital (FAH) of Xi’an Jiaotong University (XJTU) admitted a high-risk, critically ill pregnant woman at 35⁺² weeks of gestation. She was of advanced maternal age with a history of two cesarean deliveries, and presented with multiple life-threatening risks such as placenta accreta spectrum, congenital heart disease, and a positive irregular antibody screen. Her placenta accreta score reached 11, and the positive irregular antibodies markedly increased the difficulty of blood crossmatching, placing both mother and infant in critical danger. Upon admission, the FAH promptly activated the emergency response plan for high-risk pregnant women and organized a multidisciplinary consultation involving the Department of Obstetrics, Intensive Care Unit, Department of Cardiovascular Medicine, Department of Blood Transfusion, and Department of Anesthesiology. The team identified intraoperative blood supply assurance as the key challenge for successful rescue. The obstetrics team led by Professor Zong Lu prioritized emergency blood preparation as a core preoperative task and coordinated seamlessly with the Department of Blood Transfusion. The Department of Blood Transfusion immediately initiated the emergency crossmatching protocol, strictly followed special antibody matching requirements, completed precise donor unit screening and crossmatching, overcame the compatibility barriers, and established a robust blood supply safeguard for the surgery.

During surgery, the patient developed severe postpartum hemorrhage, and the pre-arranged blood supply was rapidly consumed. The Department of Blood Transfusion urgently performed additional screening and crossmatching to ensure a continuous and safe blood supply throughout the procedure. The Department of Anesthesiology implemented precise anesthesia management and conducted intraoperative autologous blood salvage and reinfusion in a standardized manner, effectively reducing the use of allogeneic blood. In this rescue, a total of 28 units of red blood cells, 3 therapeutic doses of platelets, and 1,850 mL of plasma were transfused, and 700 mL of autologous blood was reinfused. Massive hemorrhage was successfully controlled, achieving the goals of saving the mother, saving the baby, and preserving the uterus.

Postoperatively, the patient was transferred to the Intensive Care Unit for intensive care. The medical and nursing team provided systematic treatment such as anti-infective therapy and correction of anemia. Her clinical indicators gradually stabilized. At present, both mother and infant are safe, and the patient is recovering smoothly.

This rescue tested the FAH’s emergency response and comprehensive diagnostic and therapeutic capabilities in obstetrics and highlighted the strengths of multidisciplinary collaborative care. The Department of Blood Transfusion overcame major crossmatching challenges with advanced expertise, and all departments worked efficiently with professional coordination. This not only strengthened the FAH’s multidisciplinary collaboration system for emergency care of high-risk pregnant women, but also accumulated valuable experience for the rescue of complex and critically ill pregnant and postpartum women in the region.